CONTRIBUTION OF SMOKING TO EXCESS MORTALITY IN HARLEM

The New York City neighborhood of Harlem has mortality rates that are among the highest in the United States. In absolute numbers, cardiovas cular disease and cancer account for the overwhelming majority of deat hs, especially among men, and these deaths occur at relatively young a ges. The aim of this research was to examine self-reported smoking hab its according to measures of socioeconomic status among Harlem men and women, in order to estimate the contribution of tobacco consumption t o Harlem's remarkably high excess mortality. During 1992-1994, in-pers on interviews were conducted among 695 Harlem adults aged 18-65 years who were randomly selected from dwelling unit enumeration lists. The s elf-reported prevalence of current smoking was strikingly high among b oth men (48%) and women (41%), even among highly educated men (38%). T he 21% of respondents without working telephones reported an even high er prevalence of current smoking (61%), indicating that national and s tate-based estimates which rely on telephone surveys may seriously und erestimate the prevalence of smoking in poor urban communities, Among persons aged 35-64 years, the smoking attributable fractions for selec ted causes of death were larger in Harlem than in either New York City as a whole or the entire United States for both men and women. Tobacc o consumption is likely to be one of several important mediators of th e high numbers of premature deaths in Harlem.